


Engraftment

by sammyatstanford



Series: Come to Wonder [1]
Category: Supernatural
Genre: Alternate Universe - Non-Hunting, Angst with a Happy Ending, Not a Deathfic, Protective Dean, Sick Sam, childhood cancer
Language: English
Status: Completed
Published: 2016-11-18
Updated: 2016-11-18
Packaged: 2018-08-31 16:22:46
Rating: Not Rated
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 8,287
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/8585467
Author URL: https://archiveofourown.org/users/sammyatstanford/pseuds/sammyatstanford
Summary: Sam’s skin is cool through the latex as Dean strokes over the thready blue veins under the transparent skin at his wrists. His brother doesn’t so much as stir at the touch, and Dean presses, digs his fingers in beside the prominent tendon until he can feel the faint thump of Sam’s pulse. It’s supposed to be reassuring, a reminder that despite everything Sam’s still alive, but it’s not.





	

**Author's Note:**

> This story is less about medical accuracy and more about feelings, but I am fully culpable for any errors. I am not a medical professional, just a person wih google.

**NOW**

Sam’s skin is cool through the latex as Dean strokes over the thready blue veins under the transparent skin at his wrists. His brother doesn’t so much as stir at the touch, and Dean presses, digs his fingers in beside the prominent tendon until he can feel the faint thump of Sam’s pulse. It’s supposed to be reassuring, a reminder that despite everything Sam’s still alive, but it’s not.

The surgical mask over his mouth turns the air he breathes heavy and humid with his own exhalations, keeps them trapped safely where they can’t hurt his baby brother.

Dean’s eyes catch on the port at Sam’s chest, hospital gown cut low down the center to expose it.

He feels the slog of blood through his own veins.

Dean is disconnected, strung out with grief. He is lost.

He is terrified.

“It’ll be okay,” he says, voice near-robotic with reverberation through the mask. “I’m gonna take care of you. I’ve got you. I mean, that’s my job, right? Take care of my pain-in-the-ass little brother?” He tries to keep his voice light, but it hitches without his permission. One tear manages to slip out, soaks into the paper mask before he can wipe it away.

He curls his gloved hand over Sammy’s cold one, wishes he could give Sam some of his warmth.

Behind him, the door opens.

***

**THEN**

Dean’s just home from wrestling team practice, peanut butter and bacon sandwich and a glass of milk on the table in front of him. Mom usually likes to make him something, even though he’s explained to her maybe a million times that he’s capable of doing it himself and would she just sit down and relax, but today she’d been shut up in Dad’s office, talking on the phone, so he’d taken care of it.

He’s four bites in when he hears a door open, footsteps pounding up the stairs, another door slamming on the second floor. Mom comes into the room, looks at him sitting there like she’s never seen him before. Her eyes are puffy and red.

“What happened?” he says around the food in his mouth, starts climbing to his feet immediately.

She collapses into the chair across from him, and he slowly lowers back into his own. For a minute, she stares at him like she’s lost, and the food he swallows gets stuck in a lump in his throat. His heart rate picks up until he feels nauseous with the way it’s pounding, hollow _thwok_ against the thin skin of his throat

She opens her mouth three times before she starts. “The doctor called about—about Sam’s test results.”

Dean’s heart falls abruptly into the void of his stomach.

Tears start leaking out of Mom’s eyes again, and she presses her face into her hands. After a minute, she looks back up at him.

“Sam,” she starts and her voice breaks. Her nostrils flare around her deep inhale, and then it falls out of her in an uneven rush.

“Your brother has leukemia.”

Dean’s up and out of his chair so quickly that it topples, crashes to the linoleum behind him with a bang he doesn’t even register. He should stay here, be strong, comfort his mother, but he’s moving on autopilot, screaming inside his own head. He takes the stairs three at a time, has his hand on Sam’s doorknob in seconds.

It’s locked.

“Sammy!” he says, slaps his palm flat against the door, pounds on it. “Sammy! Sammy! Sammy!” He collapses, down to his knees, forehead mashed up against the cool wood and his fingernails scratching down the surface, melancholy tugging hard at his fingernail beds. “Sammy, please, please, please,” he begs into his knees.

The door opens, and Dean falls back, looks up into the splotchy, snotty, perfect face of his baby brother. He reaches out, desperate, hooks his hands around Sam’s hips, and Sam falls into him, tucks his face against Dean’s neck and sobs, stricken, horrifying sounds that shake his body apart in Dean’s arms.

Dean presses his face into the back of Sam’s neck, breathes in the smell of sweat and sick and tears.

_Sammy._

***

That first night, Dean holds Sam tight against his chest as his brother cries himself to sleep, kisses at the warmth all along his hairline again and again, whispers “I’m gonna fix this” again and again, even though he doesn’t know where to start.

“I’m gonna fix this.”

***

“ _Does Sam seem tired to you lately?” Dean asks, looking up from his geometry book to where she’s sorting mail at the counter._

_Mom frowns thoughtfully. “He is napping more often than usual. And he’s been saying he’s really sore after basketball.” Her fingers drum idly at the Formica. “I’ll ask him about it.”_

“ _Might be a good idea,” Dean agrees, turns his attention back to trying to force proofs to make any more sense to him today than they have for the last week._

_The next day, Dean walks over to the indoor field complex to pick Sam up from his intermural soccer practice. When he goes inside, Sam’s not waiting for him like usual. He’s sitting on the bleachers by the side of the field, head tilted all the way back to rest on the riser behind him, a wad of tissues pressed up against his nose. Dean wants to be annoyed—he’s got finals coming up, studying to get to—but Sam looks so small and pale under the ugly fluorescent lighting that he can’t seem to feel much but sympathy._

“ _You know, you’re supposed to hit the ball with the top of your head,” Dean jokes, collapsing down on the metal bench one higher than Sam’s sitting on, so that Sam can look at him without leaning up._

“ _Har har,” Sam says back thickly. “Didn’t hit anything, it just started bleeding.”_

“ _Must be the cold weather,” Dean says. He gives his brother a once over. There’s a dark spot on his blue jersey that’s probably blood, which Mom is so not gonna be happy about. His eyes catch on a splotch on Sam’s thigh, richly purpleblack and partially exposed where his shorts are riding up. “Jesus, Sammy,” he says, reaching down to push the fabric up higher. The bruise is huge, ugly._

“ _Did get hit there,” Sam says, voice no longer nasal because he’s taken the wad of tissues away from his nose. He dabs a little with a clean one from the box next to him, making the dried blood smeared under his nostrils flake, but he seems satisfied enough._

“ _You good?” Dean asks, and Sam nods. “Come on, let’s wash your face before we go. Can’t have the whole neighborhood thinking I beat you up.” Sam snickers, checks his shoulder into Dean’s hip when they stand up to go._

***

Sam’s out of school the next day, meeting with a specialist in the afternoon, and Dean sits in his math class and wants to tear his own hair out. He should be there, he _needs_ to be there. He’s Sam’s big brother, for fuck’s sake!

He’s got time reserved at the shop to work on his project for the spring science fair, but he skips it, heads straight home. Mom, Dad, and Sam haven’t made it back yet, and the idea of eating anything makes Dean feel sick to his stomach, so he just sits at the kitchen table and squeezes at the tender muscle above his knee and waits.

“He starts chemo tomorrow,” Mom tells him, dropping a sheaf of papers onto the kitchen table when they make it back. Sam’s already gone, disappeared up the stairs, which is what Dean expects because when things get serious like this, Sam is quiet, needs time to process. He’s so smart and careful with himself and everyone else and oh god, _oh god_ , what if—what if—

“Dean,” Mom says, and he realizes she’s standing in front of him, her hands on his face. Realizes that he’s crying. “The doctor said that there’s no guarantees, but we caught this pretty early.” She gives him a wan smile. “So just keep your chin up, okay?”

Dean nods, holds the rest of his tears at the back of his tongue, swallows them down. “I’ll just—I’m gonna go check on him,” he says, and he hugs her and kisses the top of her head because she’s smaller than him, has been for a few months now. He doesn’t understand how he’s supposed to do this, hold all of these precious things together. He’s only fifteen.

Dad is coming into the house when Dean passes by the front door, and he puts his hand on Dean’s shoulder, holds it there steady and warm for a long moment before he pats twice and nods up the stairs. “Take care of your brother.”

Dean nods, makes his way quietly up the stairs, just in case Sam’s sleeping or something. He’s surprised to find Sam not on his own bed, but Dean’s, tucked up under the super soft fuzzy Royals blanket that Sam had given him for Christmas last year. Dean hasn’t even picked out Sam’s Christmas present this year, was waiting to do it after school got out for winter break, and is Sam even going to be home for Christmas?

Sam’s got a book open in his lap, something thick and textbook-looking, and for a long moment, Dean just watches him read, the late afternoon sunlight slanting through his west-facing windows and warming up Sam’s skin. Is it just him, or does Sam look smaller? He squeezes his fists against the urge to grab his brother, to run away with him like they can outrun the sickness inside Sam’s veins. He feels empty, powerless. He’s supposed to _protect_ Sam, that’s his _job_ , but he can’t, he can’t protect Sam from this. He’s useless, completely fucking _useless_ , and he hates himself for it.

“That’s really creepy, you know,” Sam says casually, turning a page of his book.

“Shut up,” Dean replies automatically, winces at the words because what if the last thing he ever says to his brother is _shut up_. God, he’s such an asshole. His voice comes out thicker than he expects, and he realizes he’s got tears on his face again and seriously, can he just do _one_ thing to not make everything worse?

“I’m not contagious, you know,” Sam adds, and he’s still trying to sound casual but Dean knows better, can hear just that hint of a waver, and he feels like even more of a jerk.

“Duh,” Dean says, stepping through the doorway. “’m not that stupid.”

“I know,” Sam says, finally looking up from his book and giving Dean a serious look.

Dean settles onto the mattress next to his brother, leaves Sam a little space in case he needs it but feels intensely grateful when Sam shifts closer. There’s a moment of awkward maneuvering, but then Dean’s got one hand around Sam’s shoulders and the other stroking lightly at Sam’s hair as his head rests against Dean’s chest. Sam feels so little, in a way that he hasn’t felt to Dean for a few years now. His Sammy. “What are you reading?” Dean asks.

“It’s about ALL,” Sam says, and then at Dean’s questioning grunt, adds, “Acute lymphocytic leukemia. It’s what I…yeah.”

Dean reaches out his hand, pulls the book half-closed so he can see the cover. “So you got some giant medical textbook?”

He feels Sam’s shrug. “I told the doctor I wanted to learn more about it.”

Dean snorts a little laugh. “’Course you did.”

“She tried to give me a pamphlet,” Sam says, and it sounds just as petulant as Dean expects.

Dean laughs louder, and it feels good. He’s pretty sure the last time he laughed had to be yesterday, but it feels like a hundred years ago. “Brainiac.”

“I don’t understand all of it, though,” Sam continues, “so can we maybe go to the library later?”

“Sure,” Dean agrees easily. He pushes Sam’s bangs back to drop a kiss on his forehead. “Gonna play _Mario._ Tell me when you’re ready to go, okay?”

“Okay,” Sam says, turning another page.

When Sam dozes off half an hour later, Dean moves the heavy textbook off his lap, tucks the blanket up to his chin. Dean eyes the book for a long minute, _Acute Leukemias IV_ , and then cracks it open.

***

Mom insists that he go to class the next morning, says that there’s nothing he can do during the treatment anyway, that she’ll come pick him up at the end of the day and he can see his brother then. Dean yells so much he makes her cry, feels terrible about it. “I’m sorry,” he says, holding one of her hands in both of his. “I’m sorry, I’m just....”

He shoulders his backpack, walks the two miles to school because the fight made him miss the bus, spends the day staring at cinderblock walls and aching for his brother. The nurses probably all love Sam already, with his sweet smile and his earnest nature and his big brain, the smart little jokes he’s always making. He knows Sam must be terrified, but that he won’t show it, that he’ll be strong for Mom and try to make Dad proud, and Dean wants more than anything he’s ever wanted to be there, to hold his hand, to be the person that Sam doesn’t have to be strong in front of, like the time Sam was being bullied when he was nine and didn’t share it with anyone except his big brother.

Dean wishes cancer were as easy to beat up as Tim Hofstadter.

Mom picks him up at the end of the day as promised, but she doesn’t drive him home. “They want to keep Sam at the hospital for at least a little while,” she explains, knuckles white on the steering wheel, “since they’re not sure how he’ll react. Because he’s eleven, he’s considered high-risk, so they’re giving him an extra drug and, well we’ll have to see what happens.”

Dean nods. He’d read a little bit about this, but only in the medical book from Sam’s doctor, and he only managed to get through a small part of that yesterday. He needs more time to research it on his own, to talk it out with Sam the way he always does when he needs to figure stuff out. He knows it’s weird how close he is to his little brother despite their age difference, that most of his friends from school find their siblings obnoxious. But those kids aren’t Sam, aren’t clever and funny like Sam, and Sam definitely drives him insane but Sam’s also the one who understands him best, or who tries the hardest at least.

As they walk through the swooshing automatic doors of the hospital, he feels his heartbeat picking up, breath panting out of his lungs, and he follows Mom blindly off the elevator to the nurses’ station, where they talk him down from hyperventilating. He looks up into the kind eyes of the nurse who’s crouched over him. “He can’t die,” Dean says quietly, and those eyes look at him sadly.

“We’ll do everything we can,” she says sincerely, and it’s the worst non-answer Dean’s ever heard.

***

Dean’s pretty sure this can’t be a children’s hospital, because Sam looks so swallowed up in the giant hospital bed that he might disappear. He’s pale, dark circles in sharp relief under his eyes, and his smile when Dean comes into the room makes Dean’s chest hurt. He fills sick with impotent rage, anger like bile at the back of his throat because how could this happen to his Sammy, _how_ _how_ _how_? He’d give anything, _anything_ to take this away, to take this onto himself. And it’s only day one, day one of what’s going to get so much worse.

“Heya, Sammy,” and he tries to mimic the sincerity of the smile his brother gave him, but he knows he’s failing.

“Mom won’t let me do homework,” is the first thing out of Sam’s mouth.

“Uh, duh?” Dean asks, crossing the few feet of space to get to Sam’s bed. Mom had explained that Sam gets a solo room for now, until they see how the chemo will affect his immune function. “You gotta focus on getting better, buddy, not algebra or whatever.”

Sam huffs out a breath that fluffs his bangs. “I’m very good at multitasking,” he argues.

Dean puts a hand on Sam’s head. “You look tired already.”

“Dean, come on!” Sam wheedles, and that’s completely unfair because he knows that Dean is barely capable of saying no to him when he’s not dying.

_Oh god. Oh god, oh god, ohgodohgodoh—_

“Dean? Dean!” His little brother has a hand on his arm, shaking roughly, and Dean blinks and blinks until Sam’s worried expression comes into focus. “Dean?” he says again, and his voice is small, scared. Dean drops his other hand on top of Sam’s.

“I’m okay, buddy.” He takes a deep breath. “I’m okay, sorry. What were we—?”

Sam frowns at him, licks dry lips. “Um, my homework.”

“Oh yeah, right, right,” Dean says, concentrating very hard to hear Sam over the slowly quieting throb of his own pulse in his ears. How could he even _think_ that? Sam’s not—Sam’s going to be okay. Sam _has_ to be okay because Dean needs him to be.

Dean needs him.

“What do you want me to do about it?” he asks, and Sam gives him that million dollar grin.

“Just talk to Mom about it, okay? You can convince her. I can’t get behind for when I go back after all this, you know?”

Dean feels something warm slip down into the ice that’s frozen over his lungs, and he gives Sam the most genuine smile he’s managed so far. “Okay, Sammy,” he agrees.

Sam falls asleep not too much later. He was tired all the time before, and Dean read in the book last night that fatigue is often a side effect of chemotherapy, so he’s not surprised. Mom’s out in the hallway, giving them some time alone together while she figures out the kinds of logistical details that Dean can’t imagine handling right now, and he puts his finger up to his lips when she comes in.

“I’m gonna go get a snack, okay?” he whispers, waves off the money she goes to take from her purse because he hadn’t eat lunch today. Or breakfast for that matter.

He doesn’t head to the cafeteria though. Instead, he makes his way back to the nurses’ station, where the woman with the warm brown eyes—Josephine, by her name tag—is thumbing through a file. She’s wearing blue scrubs with little purple frogs on them.

“Hi,” Dean starts, and she looks up at him, tucks curly brown hair behind her ear. “I just wanted to say thanks, for um, for earlier.”

She gives him a small smile. “It’s okay,” she replies, tone sincere. “It happens. Everything okay in there?” She nods sympathetically at his shrug. “Sam’s a real sweetie.”

“Yeah,” he says. “Listen, my mom wanted me to bring something to Dr. Johansson, but she forgot to tell me where her office is and I don’t want to—well, she looked like she needed a minute. Do you think you could…?”

“Sure,” Josephine says. “She’s on the back hallway. Just go through the double doors and make a right, then the first left. Her office is number 308a.”

Dean makes his way through the maze of corridors, keeps his look purposeful so no one tries to stop him. He only gets lost twice before he finds it, door open and pretty red-haired woman behind a desk.

He knocks twice on the door frame, sharper than he means to, and she looks up quickly.

“Can I help you?” she asks politely.

“I want to talk about Sam.” He steps into the office.

Her face relaxes a little. “Oh, you must be Dean. Why don’t you have a seat?” Dean pulls out a blue-upholstered chair and drops into it, stays perched on the edge. “It’s nice to meet you.”

“No it’s not,” Dean says with a frown. “We’re meeting because my little brother is sick. That’s not nice.”

She sighs, pulls off the glasses resting partway down her nose and sets them on the desk. “You’re right,” she agrees. “But despite the circumstances, I still find that I’m happy to have met many of the people my work has led me to.” She gives him a kind smile and holds out her hand, but Dean ignores it. He doesn’t have time for social niceties.

He doesn’t feel like he has any time at all.

“I want to get tested,” he says bluntly, unbuttoning the cuff of his shirt sleeve.

“For—for cancer?” she asks, and Dean wants to put his hands around her neck for even saying that stupid word but he doesn’t.

“Jeez, no.” He’s not an idiot. “Look I’ve seen TV shows and stuff. Sam’s gonna need bone marrow, right? So I want to get tested.” He rolls up the sleeve until it’s above the crook of his elbow, holds out his arm to prove his point like Dr. Johansson is just gonna stick a needle in him right in the middle of her office. “Right now,” he says, shakes his arm at her for emphasis.

“Dean,” she says, expression morphing into something he’s just sure is a professional mask for pity, “I know that you’re scared—”

“’m not—I’m not _scared_!” Dean spits the word with derision. “I don’t have anything to be scared _of_ because Sam is going to be _fine_. He’s tougher than anyone I’ve ever known, you’ll see. He’s going to be fine, and I’m going to help him. I just—I just want to do my part, okay? Just test me so that I can help!” He realizes he’s on his feet, digging fingernails into the meat of his hands as he squeezes them tight.

“Dean,” the doctor starts calmly, gesturing firmly to the chair again with a hand. She waits until Dean falls back into it reluctantly before going on. “It’s wonderful that you’re so willing to help your brother. He’s going to need all the support he can get in the coming months. But there are steps, there’s a process. We hope at this stage that the treatments won’t need to be aggressive enough to result in destruction of the bone marrow. It’s best to just take this whole thing one step at a time, okay?”

“Then what am I supposed to do?” Dean says, _yells_ really, and suddenly all of the anger, all of the fight just leaks out of him like helium, leaving him deflated and sagging heavily against the frame of the chair. “What am I supposed to do?” he whispers, wiping furiously at the tears that try to slip down his cheeks like if he rubs them away fast enough they won’t have been there at all.

***

Dean still hasn’t told anyone what’s going on, but he thinks his parents must have called the school because his teachers all seem to be tolerating a lot more of his bullshit than usual. Or maybe he’s just being more tolerable, he’s not really sure. Every day melts into a blur. Hours locked up behind white walls, heart and mind miles away, waiting for the final bell to ring so he can rush out to his mom’s car and finally get to spend a few hours with Sammy. His friends from the wrestling team keep trying to find out what’s going on, and his science fair partner is getting increasingly pissed because Dean’s backed out on three after school sessions, but Dean doesn’t fucking care. He knows he needs to explain himself, but he can’t. Right now, this could still all be some horrible, horrible dream. If Dean says it out loud, it might make it all real.

He somehow manages to drag himself through his finals, motivated only by Dr. Johansson’s repeated promises that Sam might be able to come home soon. It’s touch and go every day, and she tells him he can’t rely on anything, but suddenly Sam is laid out in the backseat of the Impala, legs under two blankets and stretched across Dean’s lap, while Dad drives them home more slowly and carefully than Dean’s ever seen.

Sam looks small, thin and pale against the black leather, but he’s beaming, so fucking excited to be going home and Dean feels his heart thumping in empathetic response. They share a long smile, and Dean rubs his thumb over the bandages on the back of Sam’s hand, curled in his own.

Sam stubbornly refuses his help getting upstairs, so Dean hovers behind him awkwardly to make sure he doesn’t get light headed and collapse and fall or anything, trails his brother all the way to his room, where Sam smiles again at the fresh sheets on his bed, the sunlight coming in through open curtains, the Christmas lights curled around his headboard. Dean did that, but he lets Sam think it was Mom because what matters is that his brother is smiling.

***

Sam’s in the shower and Dean’s in the hallway (not pacing, definitely not pacing, he just has to keep going back to his room before he goes downstairs because he keeps forgetting stuff), and Dean hears something, like a pained whimper and then a thud. The door’s locked but they’ve been picking eachother’s for years, a stupid game Sam started as a kid because Dean told him he couldn’t, and Dean has it open in seconds with the bobby pin he keeps on top of Sam’s door frame (his brother’s too short to find it). He stumbles into the humid room, panic a tight, frantic drum in his chest, horrified at what he might find ( _Sam unconscious, Sam bleeding out into the bathtub because he fell, Sam coughing up all of his fragile insides, Sam already dead dead dead and Dean too late to save him_ ).

He rips back the shower curtain and Sam jumps under the spray of water, turns to look at him with wide, red eyes, whimpers, “My hair, Dean, my hair,” and holds out a weak hand, wet brown strands all tangled up with his fingers, a hunk that’s too large to ignore.

Dean knows with a sudden, distinct clarity what it feels like to have his heart break.

He reaches into the shower, through the spray to shut off the water. He pulls a towel off the rack, bundles his baby brother up and over the lip of the tub, dries him off slowly, carefully. The towel gets tucked around Sam’s waist, and he wraps Sam’s honeycomb wrists in one hand, draws Sam’s arms up and around his neck, turns around and tugs until Sam gets the message, presses one skinny leg up onto Dean’s flank so Dean can hook a hand underneath. The arms around Dean’s neck tighten enough that he can let go, secure Sam’s other leg up against his side, and he piggybacks his brother across the hall with Sam’s face buried against the back of his neck, water dripping from Sam’s hair under the collar of his shirt.

He leaves his brother on the mattress to wait while he digs out sweatpants, a long-sleeved shirt, and a sweater to go on top of it, bundles Sam up in layers because there’s snow on the ground outside. His own shirt is wet from the shower, but he doesn’t notice until they’re already outside and the cold spreads down his skin like the creeping touch of despair.

Dean only has his learner’s permit, but he’s a good driver, especially with his brother tucked pale and shivering into the passenger seat. Dad’s taken the truck to the shop because even with the extra help he hired on he still has to put in some face time, Mom too taking advantage of Dean’s being out of school to make up for some of the time she’s had to take off work lately, so neither of them are around to hear the distinctive rumble of the Impala’s engine turning over.

He drives them to a strip mall, parks in front of Great Clips, kills the engine. “Come on,” he says to Sam’s careful look, pats his brother on the knee to encourage him.

The shop is empty, mid-afternoon on a weekday, and a woman with a pile of curls on her head is spinning listlessly back and forth in the chair at the front counter, popping her gum. “Hi!” she says brightly. “What can I do for you boys today?”

“How much is it to get your head shaved?”

“Ten bucks.” She pops her gum again. “Which one of you?”

“Both,” Dean answers, and Sam makes a noise that’s basically a squeak (which Dean is totally gonna make fun of him for later), stares wide-eyed with shock.

“Dean?” he says, quietly. “You don’t—you don’t have to—”

“Both of us, please,” Dean says firmly to the hairdresser, giving her his most winning smile. “I’ll go first.”

Later that night, Dad gives both of them a level look over the dinner table. “So,” he starts, a forkful of roasted sweet potatoes halfway to his mouth. Mom had stared in total surprise when they came into the kitchen earlier, before she turned away, wiping surreptitiously at her cheeks as Dean set the table. “Think I should get mine done, too?” He rubs a broad-knuckled hand through his dark hair, scrubs thoughtfully at his beard.

Sam and Dean share a look, and Dean feels it, the laughter bubbling up bright like fire inside his chest before it spills out of his mouth, and then he’s laughing and Sam’s laughing and Dean can’t remember the last time he laughed, the last time he heard the bell clear sound of Sam’s laughter, too.

“Please, spare us,” Dean chokes out.

“You’d have to take the eyebrows, too,” Sam gasps out, “’cause they’re half your whole head,” and Dean roars until there are tears leaking out of the corner of his eyes, the kind of tears he doesn’t mind so much.

***

Every year on Christmas morning, Sam and Dean pile together at the top of the staircase, sitting side-by-side in their PJs and slippers and bathrobes, waiting for Mom to call them down for breakfast. It’s a sleepy, warm moment, Sam’s head on his shoulder and his arm around Sam’s back, crust in their eyes and stomachs rumbling. When they were kids, Sam would whisper to him questions about Santa, tell Dean the story of how he tried to stay up to catch the big man and failed, or did Dean think he heard those bells ringing in the dark last night? Sam had stopped believing in Santa when he was seven, but they’d still kept up the tradition. Dean’s never told Sam, but it’s one of his favorite things about Christmas.

On December 23, Sam goes back to the hospital. He’s always sick and shaky after chemo, but this time it’s too much. He can barely move, and every time he does, the nausea is overwhelming. His eyes fight to stay open and on Dean’s as they ride in the back of the ambulance together (only room for one, but Dean won’t let go of Sam’s hand, he _won’t_ , and somehow his parents accept it, follow immediately behind in the truck).

Dean’s never been so scared in his life.

Sam’s feeling slightly better by Christmas Day. Mom and Dad have gone to go get something that’s not from the hospital for all of them but Sam to eat, since, Mom says, it’s still a holiday, no matter what. There’s paper snowflakes made by the kids all up and down the hallway of the ward, a Christmas tree by the nurses’ station.

They’re playing rummy on the little detachable tray table that goes over Sam’s bed, Sam in the knit hat that one of the nurses brought him from some charity group that makes hats for kids like Sam, sick in the hospital on Christmas. It’s a jolly green and make his eyes look less dull than they have in a month. Dean runs his thumb over the edge of a card, contemplates his shitty hand.

Sam sighs. “I hope I’m better in time for school.”

Dean scoffs. “You’re not going back to school.”

Sam rolls his eyes. “I know, okay? I just mean, I want to keep up with my work is all.” Dean bites his tongue on what he wants to say. Sam’s been so fixated on school throughout this whole process, and Dean thinks maybe it’s something comforting for him. Something that’s the same, something that’s not gonna go away no matter what, something he can look forward to when this is all over. So even though he wishes his brother would turn all that attention to getting himself better, Dean just makes a non-committal noise. “How were your finals, anyway?” Sam asks. “I didn’t get to help you study this year.” He does that, likes to go through Dean’s flashcards with him or make up questions from his study guides. Another thing Dean doesn’t get, even though Sam’s explained that he likes to see all the things he’s going to be learning one day.

“Whatever.” Dean shrugs. “It’s not like I care about that right now.”

Sam drops his cards on the table. “Dean!” he says severely.

“What?” Dean replies incredulously, sets down his cards too. “I know you’ve got a hard on for your classes, Sammy, but I don’t care right now, jeez!” He puts his hand over his brother’s, bone thin and so cold. “It’s not a priority for me, okay?”

Sam shakes him off as roughly as he can manage. “No, Dean, not _okay_. What about college, huh? You think Mom and Dad are gonna be able to afford to send you after all my medical bills? No! You’re gonna need scholarships and stuff, and no one is gonna care that you got a C because your little brother was dying—”

“You’re not!” Dean interrupts fiercely, on his feet and standing over his brother before he realizes what he’s doing, hands on Sam’s skeletal shoulders and pushing Sam into his mattress, looming, heavy. “You’re not _dying_ , Sam! Jesus, don’t say that! Don’t you ever say that!”

Sam’s hands come up, those cold fingers wrapping around Dean’s wrists. He stares right into Dean’s eyes, breaks something down inside him, and Dean wants to look away but he can’t. “I might,” Sam says. “I might die.”

“No.” Dean forgets to be gentle, shakes the pile of bones under Sam’s too pale, fragile skin.

“It’s okay to be scared,” Sam says.

“I’m not gonna stay here and listen to this,” Dean answers, feels a tear slip hot and wet down his cheek until it drips off his chin, falls onto Sam’s blue hospital gown.

“Don’t leave me,” Sam says, because he’s cheap and dirty like only little brothers can be.

Dean sucks in an uneven breath. “I won’t,” he promises, curls his hands all the way around Sam’s shoulders so that he’s pulling Sam up into his chest instead of pushing him away, getting the yarn of Sam’s hat all wet with his snot and tears, little plastic table digging painfully into his ribs. Sam’s hands come up weakly to wrap around his neck.

When Dean finally lets go, it feels like something has settled into his chest, something cold and practical and hollow. It’s not good, but maybe it’s right.

“I wanted us to go to college together,” Sam murmurs as Dean’s easing him back against the bed.

“What?” Dean asks, eyes on the faint flush to Sam’s wet cheeks, more color than he’s seen there in a while.

“It’s my dream,” his brother whispers.

Dean smiles, puts a hand on his brother’s hat like there’s still hair there for him to mess up. “I’m older than you, kid.”

Sam makes a dismissive noise. “Details.”

Dean takes a tissue out of the box on the table next to Sam’s bed, dabs it over Sam’s cheeks and Sam wrinkles up his nose in complaint but lets him get away with it.

“You’d find a way to make it happen,” he agrees.

“So you gotta keep up your grades, okay?” Sam insists, picking up his cards again.

“Okay, Sammy,” he says, reluctant because he knows if he says it here then he’ll feel obligated to do it and he’s got enough to worry about right now, damn it.

“Okay,” Sam says, tone final. His hands are shaking a little—dealing with Dean’s ridiculous emotional outburst probably took a lot out of him and he doesn’t have much extra to give—but he still manages to pull four cards out of his stack, drop them face up on the table.

“Damn it.”

***

“The cancer has gone into remission for now,” Dr. Johansson says, and Dean feels like someone just yanked him 300 feet vertically into the air, everything inside him made of light and oxygen, “which is just what we want at this stage. I’m very pleased with his test results so far.”

Mom puts a hand on Dean’s knee and squeezes, her other hand wrapped up in Dad’s and is that the sun coming through the window? Has the world ever been this beautiful?

“So what now?” Dad asks, and Dean tries to get serious again because he knows Sam will want to know everything the doctor said to their parents even though she’ll explain this all to him, too.

“It’s time to progress his therapy,” she answers. “The goal now is reduce the number of leukemia cells still in the body. This process is very intense, and with Sam’s risk factors, I recommend that we continue to be just as aggressive with the chemotherapy as we were during the first phase of his treatment.”

“More chemo?” Dean interrupts, and the doctor nods, smiles at him not unkindly.

“I’m afraid it’s more important now than ever. Remission isn’t a cure—it just means that we aren’t finding leukemia cells in his bone marrow anymore, that his blood counts are returning to normal. But there is still cancer hiding out in his body, and if we don’t track it down and kill it, it will come back.”

That makes sense from everything Dean’s read on his own. Cancer is monster, and it has to be eradicated.

And so it’s back to what feels like business as usual, and Dean doesn’t understand how this can feel like his life when he lived eleven years before this with a happy, healthy, obnoxious baby brother, too bright for his own good.

Sam finally gets to come home again, and Dean forgets his birthday is coming up, but a week later he turns sixteen anyway, skips class and goes to the DMV to test for his license that morning. Sam’s too sick for the family’s traditional meal at the diner, and besides Dean doesn’t want any fanfare, doesn’t think he needs to be the focus of anyone’s attention. But Mom makes him wear a birthday hat at dinner, which he only tolerates because it makes Sam laugh, and they eat apple pear pie with a candle stuck in the middle for dessert and he thinks it could be worse. He falls asleep that night under the glow-in-the-dark stars on Sam’s ceiling, to the stories his brother tells about all the adventures they’re going to go on together, from the Grand Canyon to the Pacific Ocean and beyond.

***

Sam undergoes intrathecal therapy again, chemo drugs in his cerebrospinal fluid through a spinal tap. The treatment gave him seizures before, but this time they’re much more intense. Even with the drugs he takes to prevent them, he seems weaker than ever. Dean spends his days in a fugue state of helpless rage and grim melancholy. He’s abandoned all of his extracurriculars at this point, spends every minute he can after school gets out by Sam’s hospital bed now that he can drive himself, wheedling the nurses to push the limits on visiting hours. He keeps up with his homework religiously, starts getting up at five in the morning to meet his science fair partner. He’s finally told his friends at school what’s going on (had to, when he came back from the break completely bald), and that makes things easier in some ways but he really fucking wishes they’d all stop looking at him like Sam is gonna die any day now because Sam’s actually getting better, fuck you very much. His lab results keep coming back normal, and Dr. Johansson’s managing their expectations but things are looking good.

And some of his peers give him these looks, like it’s weird that he’s so dedicated, that he spends more time at the hospital than even his parents. But they don’t get it. Dean takes care of Sam, it’s what he does. It’s what he always has done and always will do, and if Sam needs more taking care of than usual right now, then Dean’s going to be there. Because the very last thing, the _very last thing_ that Dean could stand is if something happens to his brother and he hasn’t given up every ounce of himself, done every single thing he can trying to make Sam better.

***

This second phase of treatment, consolidation Dr. Johansson calls it, is worse than the first. Sam spends less time in the hospital, but the chemo is brutal. He comes home, so weak he can barely feed himself some nights, every bone in his body aching, skin feeling like its on fire, bruising from even the slightest bump against the furniture or railing. Dean draws him lukewarm baths in the big tub in Mom and Dad’s bathroom, uses a little of the money he saved from mowing lawns last summer to buy Sam an inflatable bath pillow and a tray to put dry things on, reads aloud from Sam’s sixth grade textbooks about magnetism and middle American history because Sam is still dedicated to keeping up as much as possible.

He starts reading other things to his brother, too, goes to the library and picks out adventure stories, stories about kids overcoming great struggles. Their favorite is _The Weirdstone of Bringsamen_. Sam loves it for the mythology, Norse tales and witches and Ragnarok. Dean loves it for its conviction, the fear it invokes, dragging him through the darkness of the mines under Alderley edge, the incredible tension, the bated breath belief that the heroes, the siblings, might actually not make it. They might not be all right in the end.

He might not be all right in the end.

***

April 2, one month before Sam’s twelfth birthday, the cancer comes back. _Recurs_ is the word Dr. Johnasson uses, looking at them with weighty sincerity as Dean’s mother bursts into tears.

“There are still many steps to take,” she reassures them.

Dean wants to bury himself.

He climbs right up into Sam’s hospital bed that afternoon, squishes himself onto the little mattress between Sam’s legs and the railing.

“I’m scared, Dean,” his brother whispers.

“It’s okay to be scared, Sammy,” he answers, rubbing his hand over Sam’s thin, hairless arm.

“It’s okay to be scared.”

***

It’s so close to Sam’s initial treatment that they have to start over again but use new, even worse drugs this time, even more aggressive treatment. Sam lives at the hospital now, and as the treatment makes his brother sicker and sicker, they keep Dean and his parents away more and more. Once the doctors realize that Sam’s bone marrow has been destroyed, he can’t even touch his brother, brief intervals in Sam’s room in a gown and gloves and mask.

They test Dean’s HLA type immediately. He’s terrified waiting for the results because what if, _what if_ , but when they tell him he’s a match, part of Dean isn’t surprised. He’s always known that he exists to be Sam’s big brother. His body exists to take care of Sam. Of course it’s meant to take care of Sam like this, too.

Dr. Johansson tells them that they’ll be better off for the transplant at a better hospital. It’s a dangerous procedure, and they need to be somewhere with more experienced doctors. There’s still steps to be taken care of here, but Mom starts making the arrangements, spends hours on the phone with other doctors, the insurance company, and Dean’s amazed again and again at how strong she is.

Dad has to sell the truck. They refinance the house. Dean gets all As for the semester. It’s worth it. It’s all worth it. For Sam, everything is worth it.

Nothing else matters.

***

Dean sits by his brother’s bedside in a Kansas City hospital, hands sweating into the latex of his gloves. “It’ll be okay,” he says, voice near-robotic with reverberation through the paper mask over his mouth. “I’m gonna take care of you. I’ve got you. I mean, that’s my job, right? Take care of my pain-in-the-ass little brother?” He tries to keep his voice light, but it hitches without his permission. One tear manages to slip out, soaks into the mask before he can wipe it away.

He curls his gloved hand over Sammy’s cold one, wishes he could give Sam some of his warmth.

Behind him, the door opens.

Dad’s hand lands, reassuring and warm, on his shoulder.

“It’s time, son,” he says, voice like they’re in church.

Dean squeezes Sam’s hand one more time, lets it fall from his own.

He stands up.

“I’m ready.”

***

It’s hot, sticky, dark, and Dean’s hands smell like gunpowder and rotten eggs and the clinging grapecherrylime residue of Skittles melting in his palm. He and Sam had set off their own fireworks already, burning sparklers out in the far back corner of the McCoy’s farmland where he’s pretty sure they won’t be caught, and now they’ve settled onto the hood of the car, crumpled candy wrappers and two empty bottles of Coke dropped carelessly by the wheel well, watching the edge of the fireworks down in town appear above the treeline.

Sam turned fourteen two months ago.

Dean looks over at his little brother, traces his eyes up the easy sprawl of his still-short legs across the Impala’s hood, encroaching on Dean’s half of the territory, the clench of his fingers in the shirt over his stomach, like he needs something to hold onto. Dean does this, stares, more than he should now, because Sam is better and he’s not supposed to have to watch him every minute. But it doesn’t matter how many months Sam’s been in full remission, how many follow-ups he comes back from healthy; Dean doesn’t know how to move on from it, that heart-palpitating fear of losing the most important thing in his entire life. In the entire world.

His hand comes up unconsciously to finger at the amulet hanging around his neck, thumb over the familiar ridges of the inscription on the flat metal disc.

When his eyes land on Sam’s face, he’s surprised by the shine of tears there. And he should say something snarky, something sarcastic to shake a laugh out of Sam’s lungs and cheer his baby brother up, but for some reason, he can’t.

“What is it?” he asks instead, slips an arm around Sam’s shoulders and pulls him close, the warmth of Sam against him impossibly hotter than the sultry July air.

Sam keeps his eyes on the distant treeline when he answers. “It’s just...it’s just sometimes I remember thinking I’d never do stuff like this again.”

The sigh of Dean’s chest moves Sam with him, too. “Yeah,” he agrees softly, brings his other arm around to pull Sam into an awkward, loose sort of hug. They settle for a moment, golden light flickering at the horizon and the thunder rumble of explosions reaching them moments later.

Sam shifts suddenly in his arms until he’s looking right up at Dean, eyes luminous and wet under the moon and he looks so serious, so weary. Dean wishes for the thousandth time he could have protected his baby brother from the things he knows, from ever having to grow up so fast.

“Thank you,” Sam says, and Dean can feel something hot flush his cheeks at the indelible sincerity of it.

“For what, Sammy?”

“For saving me,” Sam whispers, and his eyes squeeze crinkle-tight. Two more tears slip down his cheeks, and Dean can feel Sam’s breathing hitch, realizes just how close he and Sam have pressed themselves together. Sam’s eyes flutter open, salt-sticky eyelashes catching as Dean watches. “You saved me,” he says. “You saved me,” and then he leans in and plants a clumsy kiss on Dean’s mouth, right of center and cool with tears. Dean’s body reacts automatically, no need for conscious thought from his useless brain that’s skipping like scuffed-up vinyl, his hand cupping the narrow curve of bone at Sam’s jaw, their lips catchsliding as Dean turns his head until the angle is just right, until the kiss is near perfect, even better for its flaws. The heel of his hand presses against the frantic flutter of Sam’s pulse, the vital pumping of Dean’s blood through Sam’s veins.

After a moment or maybe an eternity, Sam pulls away, eyes panic-wide and chest heaving.

Dean chases the taste of sulfur and salt with his tongue.


End file.
